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Hardy, H. L., Progress Report: occupational medicine, New Eng. J. of Med.,

217 : Sept. 25 and Oct. 2, 1952.
Foreman, H., Hardy, H. L., Shipman, T. L., and Belknap, E. L., Use of calcium
EDTA in cases of lead intoxication, Arch. Indust. Hyg. and Occ. Med., 7:
148, 1953.
Hardy, H. L., An M.I.T. enterprise in occupational health, Technology Review,

15:3, 1953.
Hards, H. L., et al., Use of Calcium Ethylenediaminetetraacetate in treating
heavy metal poisoning. Report of conference held at Mass. General Hospital.
A.M.A. Arch. of Ind. Hyg. and Occ. Med., 7:137, 1953.
Isselbacher, Kurt, Klouse, H., and Hardy, H.L., Asbestosis and Bronchogenic

carcinoma. Am. Journal of Medicine, 15 : 721, 1953.
Hardy, H. L., Elkins, H. B., Ruotolo, B., Quimby, J., and Baker, W. H., Use of
monocalcium disodium ethylene diamine tetra-acetate in lead poisoning.
J.A.M.A., 154: 1171, 1954.
Sprague, F. B., and Hardy, H. L., An unusual case of joint pains and fever.
Berylliosis and pulmonary hypertension mistaken for rheumatic fever, Cir-
culation, 10: No. 1, 1954.
Hardy, H. L., Epidemiology, clinical character, and treatment of beryllium

poisoning. Progress report, A.M.A. Arch. of Indust. Health, 11: 273, 1955.
Hardy, H. L., The disability found in persons exposed to certain beryllium com-

pounds, A.M.A. Arch. of Indust. Health, 12: 174, 1955.
Ahmark, A., Friberg, L., and Hardy, H. L., The solubility in water of two cadmium
dusts with regard to the risk of chronic poisoning, Indust. Med. and Surg., 25:
514, 1956.
Hardy H. L., Differential diagnosis between beryllium poisoning and sarcoidosis,

Am. Rev. Tuberculosis and Pulmonary Dis., 74:885, 1956.
Hardy, H. L., Toxic Hazards: Current hazards of toxic beryllium compounds,

New Eng. Jour. Med., 256 : 715, 1957.
Hardy. H. L., Technological advances and their relation to industrial and public

health, The Reminder, 16; No. 3, May, 1958. (Speech to Biological Sciences
Division of the Special Library Association).
Hardy. H. L., Current knowledge of beryllium intoxication, Occupational Safety

and Health (Official Publication of I.L.O., Geneva), Apr.-June, 1958, pp. 77-80.
Cogan, D. G., Fricker, S. J., Lubin, M., Donaldson, D., and Hardy, H. L., Cataracts

and ultra-high-frequency radiation, A.M.A. Arch. of Indust. Health, 18: 299,
19.78.
Hards, H. L., Case 420: Be poisoning, Cases from the Medical Grand Rounds of
the Vass. Gen. Hosp., Ed., J. H. Knowles, Amer. Pract. and Dig. of Treatment,
9: #12, 1938.
Hardy, H. L, and Stoeckle, J. D. Beryllium disease, Jour. Chron. Diseases, 9:

1.12. 1959.
Lead Hygiene Conference, Lead Industries Association, Nov. 6–7, 1958, Chicago,

Ind. Med. and Surg., 28: March, 1959.
Hardy, H. L., Medical control of beryllium, A.M.A. Arch. Ind. Health, 9: 203, 1959.
Hardy, H. L. and Tepner, L. B., Beryllium disease: a review of current knowl-

Hilge, Jour. Occ. Med., 1:219, 1959.
Hardy, H. L., Man-Made Disease of the Nervous System. Prepared for the Com-

mission on Mental Health, 1959.
Hardy, H. L., Editorial: Honoring Dr. Alice Hamilton (90th Birthday), New

Eng. Jour. Med., 260 : 560, 1939.
Hardy, H. L., Editorial: Journal of Occupational Medicine, New Eng. Jour. Med.,

260: 610, 1939.
Hardy, H. L., Cyanide Poisoning. New Eng. Jour. Med., 261 : 619, 1959.
Hardy, H. L., South America Teaching Trip, June 19-29, 1959. Published for
private circulation. Occupational Lung Diseases. Bogota Columbia.
Hardy, H. L., Section on Dangerous Occupations, Encyclopedia Britannica, 1961.
Hardy, H. L., Hazards to Health : Criteria for Diagnosis of Occupational Disease,
New Eng. Jour. Med., 264: 1016, 1961.
Tepner, L. B., Hardy, H. L., and Chamberlin, R. I., Toxicity of Beryllium Com-
Pounds, A Monograph, Elsevier, Amsterdam, October, 1961.
Hardy, H. L., Beryllium disease: a continuing diagnostic problem. Am. Jour.

Med. Sci., 242: 150, 1961.
Hardy, H. L., Pulmonary irritants (Toxic hazards). New Eng. Jour. Med. 263 :
813, 1960.

Hardy, H. L., Occupational Medicine, chapter 17, p. 180. "The Choice of a Medical

Career". Essays on the Fields of Medicine, J. B. Lippincott Co., 1961. Edited

by Joseph Garland and Joseph Stokes, III. Hardy, H. L., Farmer's Lung, New Eng. Jour. Med. 264: 1313, 1961. Hardy, H. L., Use of chelating agents in lead poisoning. Discussion. Clinical

experience with use of calcium di-sodium ethylene tetra-acetate in the therapy of lead poisoning. Fed. Proc., Fed. Amer. Soc. Exp. Biol., Sept. 1961, Vol. 20,

No.3, part 2 (Supp. No. 10), p. 199. Hardy, H. L., Experience in the United States with proposed safe levels of ex

posure to toxic beryllium compounds. Pure and Applied Chemistry 3: 33, 1961.

Symposium, 1959, Prague, Czechoslovakia. Hardy, H. L., The definition of sarcoidosis. Am. Rev. Resp. Dis. 84: 2, 1961. Hardy, H. L., Case 40–1961. Case Records of the Mass. Gen. Hosp., New Eng.

Jour. Med., 264:1154, 1961 (Discussion). Hardy, H. L., Problems in the diagnosis of beryllium disease. Beryllium Work

shop, Kettering Laboratory, Cincinnati, O., Jan. 5–6, 1961, p. 48. Stoeckle, J. D., Hardy, H. L. King, W. B., and Nemiah, J. C., Respiratory disease

in U.S. soft coal miners : clinical and etiological considerations. A study of

30 cases, J. Chron. Dis. 15: 887, 1962. Hardy, H. L., Editorial: The will to survive, New Eng. Jour. Med. 266 : 788, 1962. Hardy, H. L., Beryllium Case Registry progress report: 1962, A.M.A. Arch. Env.

Health, 5: 265, 1962. Hardy, H. L., Reaction to toxic beryllium compounds: terminology, Jour. Occ.

Med. 4: 532, 1962. Hardy, H. L., Occupational health program in a large research institution, Jour.

of American College Health Assoc. 11 : 78, 1962. Hardy, H. L., Beryllium disease experience with investigation required to estab

lish etiology of occupational disease, Annals of N.Y. Acad. Sci. 107: art. 2, 525,

1963. McDermott, Wm. V., Jr. and Hardy, H. L., Cirrhosis of the liver following chronic

exposure to carbon tetrachloride, Jour. Occ. Med. 5 : 249, 1963. Hardy, H. L., Correct diagnosis of environmental lung disease, Proc. Seminar on

Resp. Dis. for Science Writers, Am. Thoracic Soc. and Natl. Tbc. Assoc., 1962,

p. 160.

Kranes, Alfred and Castleman, Benj. (discussion by H. L. Hardy), Dyspnea in

pipefitter 6 years after amputation of leg for sarcoma. New Eng. Jour. Med.

270: 789, 1964. Hardy, H. L. and Stoeckle, J. D., Disabling respiratory disease in U.S. Soft-coal

miners: value of intensive study of a small series of cases. Proc. XIV Int.

Cong. Occ. Health, Madrid, 1963. Hardy, H. L., Beryllium Case Registry, Letter to Physicians, 1964. Hardy, H. L., Beryllium Case Registry, American J. Clin. Path. 42: 409-10,

October, 1964. Hardy, H. L. Editorial, Asbestosis and Malignant Disease, New Eng. J. Med. 272:

590–91, March 18, 1965. Weber, A. L., Stoeckle, J. D., and Hardy, H. L., Roentgenologic Patterns in Long.

Standing Beryllium Disease, Am. J. Roentgen., Rad. Ther., and Vuc. Med. 93 :

879–90, Apr. 1965. Hardy, H. L., Asbestos Related Disease, Am. J. Med. Sci. 250: 381-89, Oct., 1965. Hardy, H. L., Beryllium Poisoning-Lessons in the Control of Man-Made Disease,

New Eng. J. Med. 273:1188-99, Nov. 25, 1965.

UNPUBLISHED MATERIAL AND MISCELLANEOUS PUBLICATIONS

Articles

Hardy, H. L., Our Polluted Atmosphere (Air), 1956.
Hardy, H. L., Our Poluted Atmosphere (Air), 1956.

Papers Presented But Not Published Hardy, H. L., Paper presented at Los Alamos Collequim, Los Alamos, N.M.,

1918, Hardy, H. L., "Current Status of Knowledge of Beryllium Intoxication", Paper

presented at Saranac Symposium, Saranac, X.Y., 1952. Hardy. H. L., Paper presented at the A.0.A. meeting, Women's Medical College

of Pa., Philadelphia, Pa., 1958.

Hardy, H. L., Paper presented to the Trudeau Society, Philadelphia, Pa., May,

1958. Hardy. H. L., "Observations on “neumoconiosis Studies Abroad", Symposium on Cardio-respiratory Diseases in Industry, McGill University, Montreal, Canada, 19.78. Hardy, H. L., “Responsibility for Man-made Disease," Y.W.C.A., Boston, Mass.,

1959.
Hardy, H. L., Paper presented at Symposium on Ionizing Radiation, Women's

Medical College of Pa., Philadelphia, Pa., 1960.
Hardy, H. L., "Occupational Pulmonary Disease”, Dearholt Lectures, Wiscon-

sin. November 7, 1960.
Hardy, H. L., Paper presented at Beryllium Workshop, Kettering Laboratory,
Cincinnati, O., Jan. 5-6, 1961. (See also Publications List, 1961).

Other
V.I.H. Progress Reports 1949–1958.
W.H.O. Working Papers 1959–1961.
Beryllium Case Registry Progress Reports 195.7–1957.
Book Reviews.

STATEMENT OF DR. HARRIET HARDY, ASSISTANT MEDICAL DIRECTOR, OCCUPATIONAL MEDICAL SERVICE, MASSACHUSETTS INSTITUTE OF TECHNOLOGY

Dr. Hardy. Senator Muskie and members of the committee, risk of harm from exposure to beryllium and its compound was first recognized in Europe in 1929 and in the United States in 1943. I began the study of this problem in Boston in 1945 and have continued my interest and attention to developing evidence of hazard associated with the use of beryllium ever since.

My training is in the field of medicine. My professional experience includes private practice (5 years), college health (5 years), and since 1945 care of patients, clinical investigation, teaching, study and control of industrial illness especially, and in recently years environmental, manmade disease. I have served at both the Massachusetts General Hospital and the Harvard Medical School as clinician and teacher since 1942. I have been assistant medical director at M.I.T. since 1949 where I am director of a group of 30 (engineers, chemists, physicists, technicians) charged with the prevention of harmful effect of chemicals, dust, and radiation associated with research and teaching in the institute community of 17,000.

What is beryllium? It is a naturally occurring nonradioactive element—the fourth lightest known to man. It is found in nature chiefly as beryl, a combination of beryllium, aluminum, water, and silica. Ores are found in the United States, Russia, the Congo, South America, usually in narrow, so-called pegmatite not easily mined.

Beryllium has been used since the 1920's alloyed with other metalssteel, copper, nickel--because it imparts lightness, hardness, heat resistance, to a remarkable degree. Beryllium in the phosphors (powders) used for coating fluorescent and neon lighting was used first in 1939.

Because beryllium gives up neutrons under alpha bombarılment it was used in the Hiroshima bomb and later in the development of nuclear reactors. Since the late 1950's beryllium has been studied for its value as a fuel for rockets. Its many properties make beryllium useful in guidance systems and in the structure of planes and spacecraft where lightness and resistance to heat and stress are critical,

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TABLE 1
Beryllium uses:

Flourescent lamps and neon signs
Nuclear reactors
Space vehicles, fuels
Guidance systems
Aircraft manufacture
Electronics (X-ray tubes, as fillers in epoxy resins)
Metallurgy-alloys (Cu, Al, Ni)

Ceramics (crucibles, refractories) From this brief summary it can readily be seen how important is complete knowledge of the evidence that beryllium and its compounds are a hazard to health.

TABLE 2 Be Compound

Diagnosis 33 Extraction of Be

Bronchiolitis 37 BeCog

"Berylliosis" (animals)

Forms of pneumonia '36 Me metal

"Metal fume fever" BezOF,

Bronchiol-alveolitis '40 Be metal

Fluorine Be vapor intoxication BeF2

Acute bronchiolitis Be,OF2

Pulmonary sclerosis '42 Be Sion

Berylliosis Be(OH)2

Chronic large celled BeSO4

pneumonia BeC1, 43 Beryl ore

Chemical pneumonia Beo '43 Beryl ore

Respiratory ailments BeF2, Beo

Dermatitis '14 Fluorescent powder

A typical pneumonitis
BeC03

Be. Mn. Silicate '45) Be metal

Beryllium poisoning Beo

Contract dermatitis Be SiO.

Contact conjunctivitis BeF2

Chemical nasopharangitis BezOF,

Chemical pneumonitis '16 Fluorescent powder

Delayed chemical pneumonitis Zn. Mn.Be. Silicate Between 1929 and 1942 reports of illness in industries using beryllium came from Germany, Italy, Russia. The illness described included disease of skin, lungs, bronchi. In 1943 and 1944 there were brief reports of an unusual phenomena of pneumonia suffered by men in the U.S. working in the beryllium industry. A much longer U.S. report in 1945 describing disease of eyes, skin, throat, bronchi, and lungs was named acute beryllium poisoning. In 1946 I reports a series of cases of illness in the fluorescent lamp manufacturing industry in Massachusetts. There were 17 cases with 6 deaths the disease so like tuberculosis that most of the patients spent some part of their illness

in sanitariums. I suggested that the beryllium in the phosphors might be the causative agent.

My suggestion arose from the combination of knowledge of European experience of illness in beryllium-exposed workers and reports of illness of similar character in other U.S. industries using beryllium. In spite of the European reports beryllium was not at this date (1946) regarded as hazardous in this country. One reason for this importan failure to recognize beryllium as harmful is the fact that a Government agency, after review of the literature performing some small animal experiments using beryllium compounds, published its conclusions that beryllium was not harmful.

Based on this Government report industry and later the Atomie Energy Commission did not take steps to control the beryllium exposure of workers or neighbors near the plants. As a result of this error in judging the evidence at hand an unknown number of people in and near beryllium-using industries in the United States were exposed to unknown amounts of beryllium for unknown periods of time. Since 1946 evidence has accumulated that every beryllium-using operation except mining beryl has caused some illness. Animal experiments here and abroad have confirmed the facts of the human illness and added the fact that in rabbits, rats, and monkeys beryllium can cause malignancies.

TABLE 3 Beryllium-using operations:

Beryllium metallurgy Be extraction, all operations Be ceramic, mixing, pressing Fluor, powder, mixing Fluor, lamps-coating, sealing, salv. Be compounds, manufacture Atomic energy development Alloy manufacture, melting, casting Alloy use, machining, grinding Seon signs, coating, cutting, repair And therefore it is difficult to know how to assess these presently socalled safe limits in the air. Now I want to conclude my statement

For your information I will review in summary some of the data collected in a central file of cases of beryllium disease (United States only) as it bears on the problem of prevention of further illness. This file, called the beryllium case registry, was begun in 1952 was the support of the Atomic Energy Commission. There are now 760 cases in the registry. Cases are admitted if there is evidence of significant beryllium exposure and objective signs of disease of the lungs, most often but not the only organ that may be involved. Significant beryllium exposure is measured by finding beryllium in tissues or body fluids or by epidemiological evidence. An example of such epidemiologic evidence would be the history that a patient worked close by another worker patient known to have beryllium poisoning.

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